Analysis of clinical status of contralateral ear in cases of unilateral squamosal chronic otitis media

Background: Squamosal COM is a condition caused by various etiological factors which are likely to affect the other side too. If diagnosed and intervened in time, the progression of the disease from simple negative middle ear pressure to cholesteatoma formation can be prevented and ear can be protected from hearing loss. Therefore it is important to assess and evaluate the contralateral ear appropriately.Methods: This prospective study included patients above six years of age suffering from unilateral squamosal chronic otitis media. Their contralateral ears were examined and assessed for any ear disease. Results: We found various conditions in contralateral ears ranging from normal tympanic membrane to various types and grades of retractions of pars tensa as well as pars flaccida and some infectious conditions too. The commonest finding was secretory otitis media (23%) and the least common was otomycosis (3%).Conclusions: Most common status in contralateral ear was found to be secretory otitis media in adult and paediatric age groups (23%). In our study, 84% of the patients showed pathology in the contralateral ear and 16% were normal, so the study proves that in patients with unilateral squamosal otitis media, with no complaints or previous history of discharge in contralateral ear shows pathology to quite a good extent¸ so the contralateral ear should always be evaluated comprehensively to efficiently diagnose any alterations and provide timely therapeutic intervention to prevent further progression of the disease and hearing loss.

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Chronic Secretory Otitis Media: Effects of Surgical Management

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894890981s202 ◽

1989 ◽

Vol 98 (1_suppl2) ◽

pp. 2-32 ◽

Cited By ~ 42

Author(s):

George A. Gates ◽

J. C. Cooper ◽

Christine A. Avery ◽

Thomas J. Prihoda

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Surgical Management ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Chronic Otitis Media ◽

Secretory Otitis Media ◽

Tympanostomy Tubes ◽

The Mean ◽

First Recurrence

To study the effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion, we randomly assigned 578 4- to 8-year-old children to receive one of the following: Bilateral myringotomy and no additional treatment (group 1), tympanostomy tubes (group 2), adenoidectomy and myringotomy (group 3), or adenoidectomy and tympanostomy tubes (group 4). The 491 who accepted surgical treatment were evaluated at 6-week intervals for up to 2 years. Treatment effect was assessed by four main outcomes: Time with effusion, time with hearing loss, time to first recurrence of effusion, and number of surgical re-treatments. For the groups (in order), the mean percent of time with any effusion in either ear was 49, 35, 30, 26 (p < .0001); the mean percent of time with hearing thresholds 20 dB or greater was 19, 10, 8, and 7 (p < .0001) in the better ear; and 38, 30, 22 and 22 in the worse ear (p < .0001); the median number of days to first recurrence was 54, 222, 92, and 240 (p < .0001); and the number of surgical re-treatments was 66, 36, 17, and 17 (p < .0001). The most notable adverse sequela, purulent otorrhea, occurred in 22%, 29%, 11%, and 24% of the patients assigned to groups 1 through 4, respectively (p < .001). In severely affected children who have chronic otitis media with effusion resistant to medical therapy, adenoidectomy is an effective treatment. Adenoidectomy plus bilateral myringotomy lowered posttreatment morbidity more than tympanostomy tubes alone and to the same degree as did adenoidectomy and tympanostomy tubes. Adenoidectomy appears to modify the underlying pathophysiology of chronic otitis media with effusion. This effect is independent of the preoperative size of the adenoid. Tympanostomy tube drainage and ventilation of the middle ear provide adequate palliation so long as the tubes remain in place and functioning. We recommend that adenoidectomy be considered in the initial surgical management of 4- to 8-year-old children with hearing loss due to chronic secretory otitis media that is refractory to medical management and, further, that the size of the adenoid not be used as a criterion for adenoidectomy. Concomitant bilateral myringotomy with suction aspiration of the middle ear contents also should be done, with or without placement of tympanostomy tubes at the discretion of the surgeon.

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A study of status of contralateral ear in unilateral chronic otitis media in 500 patients

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20195579 ◽

2019 ◽

Vol 6 (1) ◽

pp. 34

Author(s):

Prabaakharan Jambunathan ◽

Arvinder S. Maan ◽

Karan Sharma

Keyword(s):

Hearing Loss ◽

Tympanic Membrane ◽

Otitis Media ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Cross Sectional Study ◽

High Resolution Computed Tomography ◽

Cross Sectional ◽

Mixed Hearing Loss ◽

Contralateral Ear

Background: The aim of this study was to examine the contralateral ear clinically, audiologically and radiologically and compare the findings with squamous and mucosal type of chronic otitis media (COM).Methods: A cross sectional study conducted in patients attending ENT Department, Government Medical College, Amritsar between December 2016 to November 2018. The study was conducted in 500 patients of either sex aged between 8 to 60 years with unilateral COM without perforation or history of ear discharge in the contralateral ear. Otoscopy, pure tone audiometry and X-ray mastoid or high-resolution computed tomography temporal bone were done on the patients. The results were recorded and analysed with SPSS software. Results: 82% patients were found to have some abnormalities in the contralateral ear. On otoscopy abnormalities in contralateral ear includes retraction of tympanic membrane, thinning and tympanosclerotic patch, most common abnormality being retraction of tympanic membrane. Radiological analysis of contralateral mastoids showed 39% diploic and 22.8% sclerotic mastoids. Hearing status in the contralateral ear showed 45.6% patient with normal hearing, 48.6% with conductive hearing loss and 5.8% with mixed hearing loss. 40.4% contralateral ears had mild, 12% had moderate and 2% had severe hearing loss.Conclusions: Contralateral ear pathologies were more in those who had squamosal type of COM than who had mucosal type in the diseased ear. The contralateral ear shows unmistakable predilection towards developing COM in the future.

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Evaluation of the contralateral ear in patients with unilateral chronic otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20194941 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1641

Author(s):

Krupal A. Pardhi ◽

Netra A. Pathak ◽

Kiran J. Shinde

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Pure Tone ◽

Radiographic Finding ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Study Results ◽

Contralateral Ear ◽

A Prospective Study ◽

Conductive Hearing

Background: Unilateral chronic otitis media (COM) is a condition likely to affect the other side also caused by various etiological factors. If diagnosed and intervened in time, the progression of the disease can be prevented and ear can be protected from various sequelae. Hence, it is important to assess and evaluate the contralateral ear (CLE) completely.Methods: A prospective study of 12 months was conducted in the Otorhinolaryngology department, enrolling 80 patients with unilateral chronic otitis media. The CLE defined as the asymptomatic ear without ear discharge or any other complaints. Otoscopy, pure tone audiometry, tympanometry and X-ray mastoid done on patients. The results were recorded and analysed. Results: On otoscopic findings 76.36% patients in mucosal and 88% patients in squamosal showed abnormalities in CLE. Pure tone audiometry (PTA) showed 75% patients had hearing loss in CLE 46.25% conductive hearing loss (HL), 11.25% sensorineural HL and 17.5% mixed HL in CLE. In squamosal type of COM 76% patients had hearing impairment as compared to mucosal type 74.54%. In tympanometry findings 58.75% patients had type B curve in CLE. Radiographic finding of CLE showed sclerotic mastoid air cells 32% in squamosal and 9.09% in mucosal type.Conclusions: Approximately 80% patients with unilateral COM have abnormal ear findings in CLE. Squamosal type of unilateral COM had more chances of abnormalities in CLE. In this study results showed that the CLE can also be affected in unilateral COM.

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Study of ossicular chain defects in patients with chronic otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20214681 ◽

2021 ◽

Vol 7 (12) ◽

pp. 1895

Author(s):

Smita Soni ◽

Anjali A. R. ◽

Yashveer J. K.

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Age Groups ◽

Chronic Otitis Media ◽

Ossicular Chain ◽

Mastoid Cavity ◽

Sociodemographic Profile ◽

Chain Defects ◽

Recorded Data ◽

One Year

Background: Chronic otitis media (COM) is a long-standing disease of middle ear cleft and mastoid cavity having a permanent perforation in the tympanic membrane with or without discharge. It’s a worldwide health problem and it is still predominant in the modern antibiotic era. Aim was to determine the prevalence and types of ossicular chain defect in mucosal and squamosal type of COM. Also, to evaluate the hearing loss in relation to ossicular chain defect.Methods: The study was prospective observational study conducted in Bhopal over the duration of one year (January 2019 to June 2020). Patient aged 11-70 years reporting with COM were included in the study. Details regarding sociodemographic profile and extensive examination were recorded. Data was entered into MS excel 2007, analysis was done.Results: It was more prevalent in the age groups of 21-30years (39%) with female (53%) preponderance. Right sided ear was commonly involved (58%). Majority of the patients had tubo-tympanic disease (62%) whereas 38% had attico-antral disease. Ossicular chain was found intact in 33% cases. Average hearing loss was maximum (67.6 dBHL) when all ossicles are eroded. Hearing loss was minimum (33.6 dBHL) with isolated handle of malleus involvement.Conclusions: COM is one of the commonest causes of preventable hearing impairment in our society, hence early diagnosis and timely intervention is needed. Awareness among patients and doctors regarding the need for better ear hygiene is necessary.

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Evaluation of the treatment results of simple myringoplasty with tragal perichondrium in patients suffering from chronic otitis media having tympanic perforation

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2019.6_7.8 ◽

2019 ◽

pp. 55-60

Author(s):

Thi My Trang Doan ◽

Thanh Thai Le ◽

Manh Hung Ho

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Rural Areas ◽

Urban Areas ◽

Age Groups ◽

Chronic Otitis Media ◽

Common Disease ◽

Viet Nam ◽

Treatment Results ◽

Functional Symptoms

Research aims: To describe the clinical, paraclinical features of chronic otitis media with perforation and evaluation the treatment by tragal perichondrium myringoplasty. Material and method: 33 patients diagnosed chronic otitis media were treated by tragal perichondrium tympanoplasty at Hue Central Hospital and Hue University of Medicine and Pharmacy Hospital. Results: Chronic otitis media was formed to be common among females, in age groups 16-30 years. The percentage of patients in rural areas (57.6%) is higher than in urban areas (42.4%), the functional symptoms before surgery are hearing loss, tinnitus with the incidence of 100%, 87.9, these symptoms improved significantly after surgery (hearing loss decreased from 100% to 18.2% after 3 months, 6 months after surgery; tinnitus decreased by 87.9 % to 27.3% and 24.2%), the rate of closure the perforation after 3 months was 81.8%, PTA after surgery is 28.8 ± 10.6dB, up by 13.0 ± 7.4 dB. Conclusions: Chronic otitis media is a common disease in Viet Nam, affect much to life, should be detected, treated and operated timely. Tragal perichondrium myringoplasty is simple, easy to operate and has a good result. Key words: Chronic otitis media, perforation, tragal perichondrium myringoplasty, hearing loss, tinnitus

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